Lamina puncture: pars plana optic disc surgery for central retinal vein occlusion.

OBJECTIVE To determine the feasibility of creating a perivascular space adjacent to the central retinal vein at the level of the lamina cribrosa as a potential method of reestablishing perfusion in central retinal vein occlusion. METHODS Various designs for a puncture instrument, or lamina puncture lancet, were investigated in cadavers, pigs that had undergone enucleation, and in vivo rabbit eyes. RESULTS A lancet with a sharp cutting edge on one side and an opposing blunt edge is repeatedly able to create a perivascular space with limited optic nerve fiber damage. CONCLUSIONS Lamina puncture is technically feasible, and evaluation in carefully selected patients appears warranted.